Follow-Up on Universal Mental
Health Screening:Where Do We Go from Here?

September 27, 2004

Despite the fact that the Paul amendment
to prohibit funding for universal mental health screening programs in the
Labor/HHS/Education appropriations bill was not adopted, there is
good news. Concern and outrage run deep across the country over the use of tax
dollars both to screen the minds and emotions of children as young as preschool
age and then potentially to treat them with drugs that the FDA is finally
admitting are not effective and have dangerous side effects.

On the
day the Paul amendment was introduced, the highly rated and respected Internet
news service, World Net Daily carried a story about the
amendment and follow-up to the vote. People from all over the country, including
school psychologists and psychiatric nurses, called and emailed to express
support for the Paul amendment and outrage that the federal government would
even consider such a program as universal screening.
EdWatchwebsite traffic tripled that day. Fox News
ran an editorial
on their website the week after the amendment. Seven radio programs have
interviewed Dr. Effrem since the Paul amendment was introduced, and three more
are scheduled.

The public response to this is very encouraging, but still
more exciting is that policy makers in Washington are now hearing your concern
and anger. Some within the U.S. Department of Education and the U.S. Department
of Health and Human Services are willing to discuss how these programs represent
a violation of the Protection of Pupil Rights Amendment (PPRA) and the Family
Education Rights and Privacy Act (FERPA).

Members of Congress respond

House members who voted against the Paul amendment heard from their
constituents. Several of them are using the excuse that the appropriations bill
did not specifically mention universal and /or mandatory mental health screening
programs, and that the amendment was unnecessary. This excuse was actually
used by the Appropriations subcommittee chairman, Mr. Ralph Regula (R-OH),
during floor debate on the amendment.

"The Labor-HHS Appropriations Act provided funding for States to
apply for and use to provide mental health services such as those recommended
by the New
Freedom Commission. The Commission's report contained a list of
recommendations including those from Goal 4 (see page 57 of report) which are
the source of this confusion."

GOAL 4 - Early Mental Health Screening, Assessment, and Referral to
Services Are Common Practice.RECOMMENDATIONS4.1 Promote the mental
health of young children. 4.2 Improve and expand school mental health
programs. 4.3 Screen for co-occurring mental and substance use disorders
and link with integrated treatment strategies. 4.4 Screen for mental
disorders in primary health care, across the life span, and connect to
treatment and supports.

"As you can see from the recommendations of Goal 4, nothing is mentioned
about a universal, mandatory mental health screening program and the
discussion of these recommendations mentions nothing about a universal,
mandatory mental health screening program.

"Rep. Ron Paul's amendment would have prohibited funding from being used to
implement a mandatory, universal mental health screening program -- a program
which has not been created. Creation of such a program would require
Congressional action, which hasn't occurred and no one expects to occur.
Accordingly, I voted against Rep. Paul's amendment as I don't believe it is
necessary to prevent a program from being implemented that hasn't been
created."

This letter and the House Committee both actually admit that the
appropriations bill grants federal money to the states to support the
recommendations of the New Freedom Commission (NFC). Here is what the Committee
report says:

"The Committee provides $20,000,000 for the State incentive grants for
transformation ... The Committee supports the recommendations made in the July
2003 New Freedom Commission on Mental Health's report on transforming mental
health care in America. These grants will support the development of
comprehensive State mental health plans that will enhance services and
supports to persons with mental illnesses."

The above letter specifically references the New Freedom "recommendations"
and "comprehensive State mental health plans" for universal screening, but
because the actual words "universal" and "mandatory" are not used, the
Congressman thinks that these concerned constituents will be put off. Apparently
the following quotes from the recommendations and the New Freedom report do not
mean "universal" to this member of Congress:

4.2 Improve and expand school mental health programs. "Since children
develop rapidly, delivering mental health services and supports early and
swiftly is necessary to avoid permanent consequences and to ensure that
children are ready for school." (Emphasis added.)

"Schools are where children spend most of each day. While schools are
primarily concerned with education, mental health is essential to learning as
well as to social and emotional development. Because of this important
interplay between emotional health and school success, schools must be
partners in the mental health care of our children. Schools are in a key
position to identify mental health problems early and to provide a link to
appropriate services. Every day more than 52 million students attend over
114,000 schools in the U.S. When combined with the six million adults working
at those schools, almost one-fifth of the population passes through the
Nation's schools on any given weekday." (Emphasis added.)

4.4 Screen for mental disorders in primary health care, across the life
span, and connect to treatment and supports. (Emphasis added.)

Even though the word "universal" is not used, speaking of screening the
entire American school population of students and adults, as well as delivering
mental health services to "children so they are ready for school," and
screening "across the life span" sounds very universal to us. The NFC report
never uses the word mandatory either, but it is clear that states would receive
the federal money to implement the NFC recommendations. The Illinois
Children's Mental Health Act is a perfect example. As stated in the draft
implementation plan, it is clearly based on the New Freedom Commission report:

"Align systems of care with the President's New Freedom Report,
particularly the child and adolescent recommendations"

The Illinois draft implementation plan goes on to say:

"Develop a mental health system for all children ages
0-18 years that respects, supports and treats families and caregivers as
partners." "Screen all women for depression during
pregnancy and following the birth of a child up to one year post partum, and
provide necessary follow-up treatment services." (Emphasis added.)

New information has come from people monitoring the Illinois mental health
law that the states of Hawaii, Wisconsin, and New Jersey are poised to implement
similar laws and programs in those states.

What next?

Two actions are moving forward. One is stand-alone legislation (rather
than an amendment to existing legislation) that would directly oppose this
Orwellian program. Another action is an attempt to remove from the final
appropriations bill the $20 million for grants to states to implement the
New Freedom Commission's recommendations, including universal screening and
drugging with powerful and dangerous medications.

Removing the $20 million in state grants from the final bill is feasible
because the Senate is unlikely to actually pass its version. Numerous
controversies and possible amendments to the bill make its passage before the
November election extremely difficult. Funding for these three high profile
departments, therefore, can only occur under one of two scenarios.

The first scenario is a continuing resolution which would maintain
funding for all programs at current levels, not allowing funding any new
programs such as the state grants to fund the New Freedom recommendations.
This scenario is desirable if Congress extends funding for most or all of next
year. It is much less desirable if funding extends only through the election,
after which a lame duck session would decide. Lame ducks are not so accountable
to the voters.

The second scenario is passage of an omnibus bill to fund all the
programs, including new ones like the New Freedom state grants. In an omnibus
bill scenario, leaders in the House and Senate determine what goes into the
legislation, and it cannot be amended. Only an up or down vote is
allowed. This scenario requires convincing Congressional leaders to strip
the grants to fund New Freedom recommendations out of the bill before the
single House and Senate vote.

What You Can Do:

1) Stay tuned and be ready to support the stand-alone legislation to
prevent universal mental health screening programs.

2) If your House
Member voted against the Paul amendment, use the information in this alert to
explain to him or her that these programs truly are universal and that states
plan to make them mandatory.

3) Send a request to your House member and
both Senators by phone, fax, or email, that they support a continuing
resolution with no funding for new programs, or that if there is an omnibus
bill, that the state incentive transformation grants to fund the New Freedom
Commission recommendations be stripped out.

4) Let your state
legislators know, especially during this campaign season, that you do not want
a mandatory universal mental health screening program in your state, as is
being done in Illinois and planned for New Jersey, Wisconsin, and
Hawaii.

5) Your case for discussing any of the above items can
be made stronger if you purchase the briefing book now available from EdWatch
that contains hard copies of nine articles by Dr. Karen Effrem, Dr. Dennis
Cuddy, Penny Pullen, and Karen Hayes. The CD-rom contains all of those
articles plus a Power Point presentation with evidence to bolster your case
and excerpts of a radio debate between Dr. Effrem and a member of the New
Freedom Commission